The Dermapen microneedling device provides an unparalleled
response via the fractional delivery of micro-needles, creating micro-injuries
to the epidermis and dermis. These micro-injuries to the skin encourage and
harness the power of the body’s innate ability to repair the skin through the
normal physiology of skin. The first phase begins with the release of the
bodies growth factors and the further cascade of new epidermal growth,
fibroblast chemotaxis, fibroblast proliferation and matrix production. This
proliferation of the body’s tissue continues to release growth factors from
fibroblasts, keratinocytes and monocytes. The second phase of wound healing
involves deposition of collagen III, IV and I, elastin, proteoglycans, and
GAGs. The last phase results in tissue remodeling where the skins vascular
matrix matures and skin tightening. The body’s ability to heal itself is at the
heart of this amazing process.
What makes Dermapen
Different:
The closest technology to the Dermapen is a fractional
laser. A fractional laser “drills holes” in the skin to create a wound healing
response and leaves normal tissue around the holes to be a reservoir for
fibroblasts and stem cells to migrate into the holes. Fractional radiofrequency
devices work on a similar principle and have many of the same side effects as
fractional lasers (Yeung et al., 2012). Dermapen also makes holes in the skin
to create a wound healing response and leaves normal tissue around the holes.
These technologies have similar results, but achieve them in very different
ways, and result in very different side effects profiles. The laser uses light
to char and obliterate epidermis to produce small pits which vary in diameter
and depth, depending on the laser type (Erbium, YAG, CO2; nonablative vs
ablative) and manufacturer. Dermapen produces reproducible and consistent holes
in the skin.
Side effects differ between technologies. Most fractional
lasers leave erythema and edema up to 96 hours after treatment. Resultant
downtime is approximately 3-4 days for fractional laser treatments (Gold,
2010). Dermapen treatments result in erythema with slight chance of edema for
about 24 hours. Common side effects of fractional lasers are:
Pain (higher in dark skined patients (Mahmoud et al., 2010)
Persistent erythema
(Gold 2010)
Infections (viral and bacterial). Facial herpes reported in
10.6% of patients in spite of antiviral prophylaxis (Naouri et al., 2011)
Post inflammatory hyperpigmentation in up to 18%
(Vaiyavatjamai and Wattanakrai, 2011; Chan et al., 2010; Mahmoud et al., 2010;
Yeung et al., 2012)
Postinflammatory hypopigmentation – seen in patients up to
two years after a laser treatment. Occurs in up to 20% of patients with
photo-aged skin (Gold 2001).
Light based therapy is not for all skin types. For example,
the indications for use cleared by the FDA may put limits on the skin types
that may be treated with a fractional laser. For example, the indications for
use may prohibit the use of the laser on Fitzpatrick 4, 5 , and 6 (darker skin
colors), for example: “The EXELO2 with the fractional scanning unit is
indicated for ablative skin resurfacing in people with skin types 1, 2 or 3
based on Fitzpatrick skin type scale.” K090639. The fractional holes “drilled”
by the laser are a function of skin type, skin thickness, and vascularity. Dermapen
does not rely on skin color to turn light into heat.
A major complication from light based therapy includes
Postinflamatory Hyperpigmentation (PIH) in Oriental, Mediterranean, and African
skin types (Yeung et al., 2012; Metelitsa and Alster 2010; Chan et al., 2007).
PIH presents as symmetric hyperpigmented macules and patches on the face. PIH
is one of the most common and distressing pigmentary disorders seen in
dermatology clinics. It is notably difficult to treat and may relapse.
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